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Title: | Acute Stroke Management in Türkiye: Intravenous Tissue Plasminogen Activator and Thrombectomy NöroTek: Türkiye Neurology Single Day Study | Other Titles: | Türkiye’de Akut İnme Yönetimi: IV tPA ve Trombektomi NöroTek: Türkiye Nöroloji Tek Gün Çalışması | Authors: | Topçuoğlu, M.A. Özdemir, A.Ö. Arsava, E.M. Güneş, A. Aykaç, Ö. Gencer, E.S. Çabalar, M. Yayla, Vildan Erdoğan, Hacı Ali Erdoğan, Mücahid Acar, Zeynep Özdemir Şener, Ufuk Yıldız, Özlem Kayım Bolayır, Aslı Kısabay, Aysın Baştan, Birgül Acar, Zeynep Niflioğlu, Buket Güven, Bülent Kaya, Dilaver Baş, Demet Funda İnce, Fatma Birsen Afşar, Nazire Yazıcı, Duran Toplutaş, Eren Özkan, Esra İlik, Faik Büyükşerbetçi, Gülseren Aslan, Yıldız Önder, Halil Karadeli, Hasan Hüseyin Kozak, Hasan Hüseyin Demirbaş, Hayri Midi, İpek Aydın, İsa Can, Ufuk Demir, Turgay Epçeliden, M. Tuncay Atmaca, Murat Mert Bakar, Mustafa Şen, Mustafa Turgut, Nilda Keskin, Onur Akdoğan, Özlem Emre, Ufuk Bilgili, Özlem Demir, Tülin Şirinocak, Pınar Bekdik Yevgi, Recep Akkaş, Sinem Yazıcı Çınar, Bilge Piri Dora, Babür Yoldaş, Tahir Duman, Taşkın Atasoy, Tuğrul Özel, Tuğba Öztürk, Şerefnur Ünal, Ali Giray, Semih Kablan, Yüksel Tanrıverdi, Zeynep Tekan, Ülgen Yalaz Asil, Talip Akpınar, Çetin Kürşad Yürekli, Vedat Ali Acar, Bilgehan Akçakoyunlu, Merve Şirin, Hadiye Güler, Ayşe Baydemir, Recep Krespi, Yakup Öcek, Levent Çetiner, Mustafa Nazlıel, Bijen Çağlayan, Hale Batur Ongun, Nedim Eren, Alper Arlıer, Zülfikar Cenikli, Utku Gökçe, Mustafa Özkul, Ayça Bavli, Songül Yaka, Erdem Özdemir, Gökhan Değirmenci, Bahar Aluçlu, Ufuk Işıkay, Canan Togay Aslanbaba, Eda Sorgun, Mine Aytaç, Emrah Ay, Halil Kunt, Refik Şenadım, Songül Eşkut, Neslihan Ünsal, Yaprak Özüm Bozdoğan, Zehra Alioğlu, Zekeriya Yılmaz, Arda Genç, Hamit Yılmaz, Ayşe Milanoğlu, Aysel Gürkaş, Erdem Değirmenci, Eylem Bektaş, Hesna İlgezdi, İrem Bilgiç, Adnan Burak Yılmaz, Zahide Akyol, Şenol Güngör, Levent Kale, Nilüfer Çoban, Eda Yeşilot, Nilüfer Ekizoğlu, Esme Kizek, Özgü Kurşun, Oğuzhan |
Keywords: | Acute stroke metric prognosis thrombectomy thrombolytic therapy treatment window tissue plasminogen activator adult aged Article bleeding blood clot lysis brain infarction cerebrovascular accident computer assisted tomography demographics female hospitalization human intensive care unit length of stay major clinical study male mechanical thrombectomy mortality National Institutes of Health Stroke Scale neurothrombectomy nuclear magnetic resonance imaging prognosis Rankin scale recanalization revascularization thrombectomy |
Publisher: | Turkish Neurosurgical Society | Abstract: | Objective: To reveal the profile and practice in patients with acute stroke who received intravenous tissue plasminogen activator (IV tPA) and/or neuro-interventional therapy in Türkiye. Materials and Methods: On World Stroke Awareness Day, May 10, 2018, 1,790 patients hospitalized in 87 neurology units spread over 30 health regions were evaluated retrospectively and prospectively. Results: Intravenous tPA was administered to 12% of 859 cases of acute ischemic stroke in 45 units participating in the study. In the same period, 8.3% of the cases received neurointerventional treatment. The rate of good prognosis [modified Rankin score (mRS) 0–2] at discharge was 46% in 83 patients who received only IV tPA [age: 67 ± 12 years; National Institutes of Health Stroke Scale (NIHSS): 12 ± 6; hospital stay, 24 ± 29 days]; 35% in 51 patients who underwent thrombectomy (MT) alone (age: 64 ± 13 years; NIHSS: 14.1 ± 6.5; length of hospital stay, 33 ± 31 days), 19% in those who received combined treatment (age: 66 ± 14 years; NIHSS: 15.6 ± 5.4; length of hospital stay, 26 ± 35 days), and 56% of 695 patients who did not receive treatment for revascularization (age: 70 ± 13 years; NIHSS: 7.6 ± 7.2; length of hospital stay, 21 ± 28 days). The symptom-to-door time was 87 ± 53 minutes in the IV treatment group and 200 ± 26 minutes in the neurointerventional group. The average door-to-needle time was 66 ± 49 minutes in the IV tPA group. In the neurothrombectomy group, the door-to-groin time was 103 ± 90 minutes, and the TICI 2b-3 rate was 70.3%. In 103 patients who received IV tPA, the discharge mRS 0–2 was 41%, while the rate of mRS 0–1 was 28%. In 71 patients who underwent neurothrombectomy, the mRS 0–2 was 31% and mRS 0–1 was 18%. The door-to-groin time was approximately 30 minutes longer if IV tPA was received (125 ± 107 and 95 ± 83 minutes, respectively). Symptomatic bleeding rates were 4.8% in IV recipients, 17.6% among those who received only MT, and 15% in combined therapy. Globally, the hemorrhage rate was 6.8% in patients receiving IV tPA and 16.9% in MT. Conclusion: IV thrombolytic and neurointerventional treatment applications in acute ischemic stroke in Türkiye can provide the anticipated results. Heterogeneity has begun to be reduced in our country with the dissemination of the system indicated by the “Directive on Health Services to be Provided to Patients with Acute Stroke.”. © Copyright 2023 by the Turkish Neurological Society / Turkish Journal of Neurology published by Galenos Publishing House. | URI: | https://doi.org/10.4274/tnd.2023.70292 https://hdl.handle.net/11499/56519 |
ISSN: | 1301-062X |
Appears in Collections: | Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection Tıp Fakültesi Koleksiyonu WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection |
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